Many women assume that fertility is solely influenced by age or a regular menstrual cycle. However, there's another factor that's often overlooked: egg reserves can gradually decline without causing any symptoms.
Because it doesn't always cause symptoms, many women only discover this condition after trying to conceive for a long time without success. However, early screening can help identify fertility issues sooner and determine appropriate treatment.
What is an Egg Reserve?
The egg reserve is the number and quality of eggs remaining in the ovaries. From birth, women have all the eggs they will use throughout their lives. As we age, the number of eggs naturally decreases.
However, in some women, this decline can occur more rapidly than expected. This condition is known as diminished ovarian reserve .
What often goes unnoticed about this condition is that menstruation can still be normal. Therefore, many people believe they don't have a fertility problem until they start having difficulty conceiving.
What Causes a Decrease in Egg Reserves?
Age is the most common cause, especially after the age of 35. However, several other conditions can also affect egg reserves, such as:
- Endometriosis
- History of ovarian surgery
- Chemotherapy or radiotherapy
- genetic factors
- Smoking habit
- Autoimmune disorders
In some cases, decreased ovarian reserve can even occur without any clear cause.
What are the symptoms?
Most women don't experience any specific symptoms. However, some signs that may appear include:
- Menstrual cycles start to become shorter or irregular
- Difficulty getting pregnant even though you have regular intercourse
- Pregnancy program that has not been successful within a certain time
Because symptoms are often non-specific, fertility testing is important, especially for couples planning a pregnancy.
How to Find Out?
To determine the condition of egg reserves, doctors will usually carry out several examinations, such as:
- AMH ( Anti-Müllerian Hormone ) hormone examination
- FSH and estradiol hormone examination
- Transvaginal ultrasound to see the number of ovarian follicles
This examination helps assess the condition of the ovaries and estimate the chances of success of the pregnancy program.
However, it's important to understand that a decreased egg reserve doesn't necessarily mean a person can't conceive. Pregnancy is still possible, but the chances may be reduced and more targeted treatment may be required.
When Should You Consult a Doctor?
Examination by a fertility and reproductive endocrinology specialist is recommended if:
- Age over 35 years and planning a pregnancy
- Not pregnant after trying for some time
- Have a history of endometriosis or ovarian surgery
- Menstrual cycles begin to change
- Having a history of premature menopause in the family
The sooner the condition is identified, the greater the chance of determining appropriate treatment options.
EMC Cikarang Hospital provides consultation services with obstetricians and gynecologists specializing in fertility and reproductive endocrinology to assist with fertility evaluation, ovarian reserve testing, and comprehensive pregnancy planning.
This article was written by Dr. dr. Edo Rezaldy E, Sp.OG, Subsp. FER, SH, MH (Obstetrics and Gynecology Specialist, Fertility Subspecialist - Reproductive Endocrinology, EMC Cikarang Hospital).